Groundbreaking concussion test developed

A brand new saliva test could see concussions detected on the sideline within minutes of a player being removed for a HIA.

Researchers at the University of Birmingham have developed a swab test to detect a concussion in athletes.

A study published in the British Journal of Sports Medicine has found that a group of 14 biomarkers appear in the saliva of an athlete that has been concussed.

The research, named Study of Concussion in Rugby Union through microRNAs (SCRUM) collected saliva samples from more than 1,000 professional rugby players in English rugby’s premiership and championship.

Players gave saliva samples out of competition to lay a benchmark, before being swabbed during matches if they were removed from play due to injury, immediately after matches and 24-48 hours after matches.


The markers appear within minutes of a player suffering a concussion and can remain for up to 48 hours, allowing for the detection of concussions after matches and training. The test has an accuracy rate of 96 percent, which is above the HIA accuracy rate of 94 percent.

Lead researcher Dr Valentina Di Pietro said the swab test can be used alongside the current Head Injury Assessment protocol used by competitive sport including the NRL once the technology becomes available for sideline testing.

“In professional sports, this diagnostic tool may be used in addition to current head injury assessment protocols and return to play evaluation to ensure the safety of individuals,” she said.

“Currently, the test would be used alongside existing injury assessment protocols to support and enhance the accuracy of concussion diagnosis. After the injury, team physicians would collect saliva (the process takes a few minutes) and mail it to an accredited lab for analysis. After the lab receives and processes the saliva sample, the biomarker evaluation algorithm would determine the probability of concussion.”

Professor Antonio Belli from the University of Birmingham added that the speed of the test is a crucial factor in its effectiveness.

“Crucially, the differences in the salivary concentration of these biomarkers are measurable within minutes of injury, which means we can make rapid diagnoses.

“The ability to rapidly diagnose concussion using biomarkers in addition to existing tools solves a major unmet need in the sporting world as well as in military and healthcare settings, particularly in injuries without significant visible symptoms,” said Professpr Belli.

“In this study, saliva samples were collected at pitch side and we were able to identify a clear signature within minutes from the event of concussion. Therefore in the near the future, pitch-side analysis may be possible using portable equipment when the technology will become available,” said Dr Di Pietro.

The prospective introduction of a quick swab test to detect concussion would be invaluable for the NRL as concussion has once again become a large talking point.

While former player James Graham has declared he would have given his life to play the game, the protection of players is still paramount.

In recent years former players who have died and donated their brain to science have been found to have been suffering from CTE, while a number of high profile former players have declared they would be donating their brain to the brain bank for future study.

The NRL has also looked to tighten its HIA protocol, requiring teams to gain independent approval from a neurologist if a player suffers a concussion should they wish to play within 11 days of suffering the injury.

There is also concern around the playing futures of Roosters players Boyd Cordner and Jake Friend.

Cordner is expected to be out until the middle of the year after being concussed during the State of Origin series last year, while Jake Friend suffered a concussion in round one and a return date hasn’t been set as the club sends him for independent assessment.

Across round three of the 2021 NRL season, seven players suffered concussions on Saturday and Sunday alone, nearly double the average concussion rate per round of 3.6 across the 2019 and 2020 seasons.

The high rates of not only concussions and Head Injury Assessments have seen calls for a concussion substitute to be introduced to offset the impact those injuries have on games and to promote player safety.


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